阴沟肠杆菌等细菌超广谱β-内酰胺酶检测的探讨

Detection of extended-spectrumβ- lactamases in members of the family Enterobacteriaceae with double-disk and VITEK-ESBLs test

目的 检测肠杆菌科细菌中除肺炎克雷伯菌、产酸克雷伯菌、大肠埃希菌以外的其它细菌超广谱 β 内酰胺酶 (ESBLs) ,以了解其检出情况和耐药性。方法 采用VITEKESBLs检测系统和双纸片协同试验同时进行ESBLs的实验。结果 2 80株细菌中 ,用VITEK5 0 6卡检出ESBLs菌 96株 ,其中大肠埃希菌 34.5 % ,肺炎克雷伯菌 4 3.1% ,阴沟肠杆菌 35 .4 % ,产气肠杆菌 2 5 % ,费劳地枸橼酸杆菌 37.5 %。用双纸片协同实验检出 91株 ,检出率略低。在沙雷菌、变形杆菌、摩根菌中未检出ESBLs菌。对头孢西丁药敏试验中 ,产ESBLs的大肠埃希菌、肺炎克雷伯菌高度敏感 ,而其余细菌表现耐药。结论 对大肠埃希菌 ,肺炎克雷伯菌可以用VITEK系统和双纸片协同试验作常规ESBLs的试验 ,而对肠杆菌科中其余的细菌是否可参照应用尚需研究。

Objective To investigate the distribution of producing extended spectrum β lactamases(ESBLs) bacterium in our hospital. Methods Using VITEK ESBLs test and double disk test to detect ESBLs in members of the family Enterobacteriaceae . Results Among 110 stains of E.coli , 65 stains of K.pneumoniase , 65 stains of E.cloacae , 16 stains of E.aengense and 9 stains of C.freundii , the VITEK ESBLs test showed the producing ESBLs 34.5% , 43.1%, 35.4%, 25% and 37.5% respectively. The double disk test showed 34.5%, 43.1,32.3%, 12.5% and 25% respectively. And the latter is lower. We have not found ESBLs in serratia spp, proteus spp and M.morganii . All producting ESBLs E.coli and K.pneumoniase were susceptible to cefoxitin, other Enterobacteriaceae were resistant. Conclusion The VITEK ESBLs and double disk tests are suitable for detecting the producing ESBLs in routine work.